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The OCULUS Keratograph 5M

The OCULUS Keratograph 5M is an advanced corneal topographer with a built-in real keratometer and a color camera optimized for external imaging. Unique features include examining the meibomian glands, non-invasive tear film break-up time and the tear meniscus height measurement and evaluating the lipid layer.

Topographer OCULUS Keratograph 5M

OCULUS Keratograph 5M

Dry Eye Examination

Can the NIKBUT measurement be performed even in severe dry eye?

The NIKBUT measurement for dry eye with severe corneal epithelial damage is difficult. Even when the NIKBUT measurement is performed in such cases, the device mostly reports the results as “too short”.

Is the NIKBUT value the same as fluorescein tear film break-up time (TFBUT)?

The differences between fluorescein TFBUT and NIKBUT values should be noted, although positive correlation between TMH and Schirmer test values has been reported.

Why are white areas sometimes displayed in the colour-coded map of the NIKBUT display?

White areas are displayed if the patient blinks before 15 seconds after the measurement started. This does not affect the measurement in any way.

Does abnormal corneal shape i.e. keratoconus affect the NIKBUT measurement?

No, the software detects a basic image. In the case of keratoconus for example the strained Placido rings induced by the condition is noted initially by software and distortions from the original image is recorded and indicated as a break in the tear film. However, in cases with advanced keratoconus or severe irregular corneal astigmatism, it is hard to perform the measurement.

Does the nose shadow affect the NIKBUT measurement?

No, the area being analyzed during the NIKBUT measurement usually doesn’t coincide with the area affected by the nose shadow.

What is important when measuring tear meniscus height (TMH)?

At least three measurement points (nasal and temporal limbus, pupil center) should be selected. To get the right value the ruler has to be placed on the lid margin and measure perpendicular up to the last reflex of the meniscus. Please see image as reference. The correct measurment is 0.22 mm for this example.

Are the meibomian glands graded objectively by the software?

No, however grading scales called the JENVIS Grading Scales for meibomian glands have been included in the software. A sliding bar tool allows for direct comparison of patient results to the grading scale, making meibo grading very easy with the Keratograph 5M.

In some cases, R-Scan evaluating bulbar redness cannot detect the conjunctival area correctly.

In eyes with small lid aperture or eyes with ptosis, (commonly seen in the older Asian population), the device cannot detect the conjunctival area correctly.

What are the particles being observed during the tear film dynamic examination?

The particles are a combination of eroding corneal epithelial cells, tarsal conjunctival cells and small air-particles.

The JENVIS Pro Dry Eye Report is a comprehensive dry eye report. Does this report diagnose the condition of the eye?

The purpose of the JENVIS Pro Dry Eye Report is to provide the clinician with various dry eye related examinations, improving workflow, aiding in the diagnosis and educating the patient. The clinician uses the results from the JENVIS Pro Dry Eye Report to formulate the diagnosis. Treatment options are included in the software, however these are chosen at the discretion from the clinician. Different treatment suggestions can be manually added.

Various tests are included in the JENVIS Pro Dry Eye Report, does all of the tests need to be performed on every patient?

No. The report is set up to allow clinicians to individualize the screening procedure if they so require. A screening option, consisting only 4 procedures, is also included. This is a good tool to screen every patient entering the clinic. If a problem is detected, more detailed examination with an individualized report can follow.

In which sequence should dry eye tests be performed?

It is important to start from least invasive followed by more invasive tests. The workflow in the JENVIS Pro Dry Eye Report is set up to accommodate this principle.

Can data from the Keratograph be exported for research?

Yes, data from the NIKBUT, R-Scan and all keratometric data can be exported to csv files.

Topography/Contact lens fitting

The Keratograph has 22 Placido rings to perform a measurement. Does this generate sufficient information about the cornea?

Yes, with the 22 Placido disc 22.000 real measured data points are generated after each measurement. None of these are extrapolated measurements.

Does the Keratograph measure simKs?

Yes, a real keratometer is included in the hardware measuring simKs of the anterior surface.

Does the Keratograph measure the posterior cornea?

No, the Keratograph is a Placido topographer. Placido discs are projected on the tear film, the software analyzes the resulting images and measurement data of the anterior cornea is generated. No, a Pacido topographer can measure the posterior cornea on its own.

How does the Keratograph aid in keratoconus diagnosis?

Topographic indices for keratoconus screening are incorporated in the software, as well as Fourier Analysis. Objective inspection of the sagittal map is another tool to aid with diagnosis.

The OxiMap® displays oxygen transmissibility of a soft contact lens. Can any lens on the patient’s eye be measured?

No, lenses cannot be individually measured. Well-known soft lenses were analyzed and the information is programmed into the software. The role of the OxiMap® is to educate patient’s on the importance of using lenses with high oxygen transmissibility, showing them the benefits in an easy to understand image. Furthermore the OxiMap® gives information about the oxygen transmissibility over the entire surface of the lens, as well as differences between prescriptions.

Data of various lenses are included in the Contact Lens Fitting display. Can data for other lenses be imported too?

Yes, data from any lens can be manually input if the parameters are known.

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